OSP Assigned
Proposal Code
UNIVERSITY OF CENTRAL MISSOURI
SPONSORED PROGRAMS, WDE 1800
INTERNAL ROUTING SHEET
Program Code
This routing sheet and attachments must be reviewed by OSP prior to a proposal being submitted to an external agency.
Please allow five working days for OSP review. Attachments must include a complete copy of the full final proposal to be
submitted, detailed budget, and URL or funder guidelines. Signatures must be obtained prior to submission to OSP.
Project Information:
Project Title:
Type project title here
(max 256 characters)
Funding Agency Name:
Begin Date:
Type the name of the agency/institution UCM will receive its funding from
1/1/01
Funder Due Date:
End Date:
1/1/01
1/1/01
Total Amount Requested:
$1,000,000
Project includes ARRA (stimulus) funding:
Principal Investigator Information:
Yes or No
Additional investigators should complete the Co-PIs Signature Page.
Investigator Name: Person responsible for project
Banner ID (7 number): 700000000
Departmt Org Code: UCM dept that will perform project
Campus Address: Investigator's Campus Address
Campus Phone: Investigator's campus phone
Other Phone Add'l/Off Campus Phone
List additional Banner users and their 7 numbers who should have access to financial information for this project:
Add names and employee 7 numbers for individuals other than the PI who should view this budget in Banner.
Cost Sharing (additional form is required if project has cost share):
None
Mandatory
Voluntary
$0
Amount
0%
Percent
Project Income:
No
Yes
Budget Summary (attach detailed budget):
Funder
Direct Costs
F&A Costs
Total
0.00%
$
$
$
+
+
+
Proposal Status (choose one):
Pre-proposal (as defined by
funder)
Restricted
Not Restricted
UCM In-Kind
Cost Share
$
$
$
UCM Cash/Personnel
Cost Share
$
$
$
+
+
+
New Proposal (new contract
and budget period)
$0
Amount
Project Total
=
=
=
$
$
$
Supplemental Funding (for
current project)
Funder Category (choose one):
Federal**
State with fed pass through**
Foundation – Nat’l
Foundation – State
00.000 **CFDA# required on Federal/State pass-thru
State
Project Sub-Category (choose one, contact OSP for assistance):
Academic Support (support of
Research (individual and
institution’s primary missions)
organized centers for research)
Public Service (non-instruction)
Instruction (community/on/off)
Student Service (non-instruction)
Capital (capital development)
Other
Institutional Support
(management/administration)
Scholarships/Fellowships
Updated 11/13/09
Special Considerations/Compliance (choose all that apply, additional documents may be required):
New hires
Faculty or staff time
Grad or UG time
Credit courses
Patents
Vertebrate animals
Human subjects
Hazardous materials
Copyright
Intellectual property
Subcontracts
Space or equipment
Volunteered
personnel time
Shipments out of
United States
Commitments
beyond grant period
Conflict of interest or
commitment
Export controlled
technology, items, info
External collaboration or
partnerships
Interaction w/ U.S.embargoed countries
Foreign travel
Project Summary/Abstract (used in on/off campus media/reports, please e-mail to your Project Administrator):
This space is limited. In addition, please forward your project summary/abstract to your project administrator via e-mail
INVESTIGATOR CERTIFICATION (initial each line below and sign):
1.
2.
3.
4.
5.
6.
7.
I am not delinquent on any federal debt and am not presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from current transactions by any federal
department or agency;
I have not and will not lobby any federal agency on behalf of this award;
I agree to abide by all funder policies, university policies and Academic Procedures and Regulations,
and provide sound budget and programmatic administration for this project;
I agree to be bound by the terms and conditions of the grant or contract which supports this
proposed activity including all university policy; and,
I have completed all prior commitments on sponsored projects and am in good standing on those
projects; and,
I approve the use of all information provided in this document in press releases and on and offcampus publications; and,
I understand my department/college will be responsible for payment of any vacation payout or
longevity pay which may be due to employees that are grant funded at the time of their termination
of employment with University of Central Missouri.
Principal Investigator Signature
Date
UNIVERSITY APPROVALS:
The attached proposal has been reviewed by the supervisors, directors, department chairs, deans and/or vice presidents
whose signatures appear below. Signatures indicate support and approval of the project and the assumption of responsibility
on behalf of the submitting units to conduct the project and provide all resource commitments contained in the application
and budget. Signatures further indicate if vacation is accrued by any personnel on this project, the represented departments,
offices, and colleges accept responsibility for payment of any necessary accrued vacation payout and longevity pay.
Sponsoring Director/Chair Signature
Date
Sponsoring Dean/Vice President Signature
Date
OSP Review
Date
Updated 11/13/09